Sarcoidosis in north African people: about 35 cases
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Keywords
: Sarcoidosis, Intrathoraciclymphnodes, chest high-resolution computed tomography, prognosis
Abstract
Background and aim: Sarcoidosis is a systemic disease of unknown cause characterized by the formation of non-caseating granulomatous inflammation in various organs, mainly lungs and intrathoracic lymph nodes. Its clinical and paraclinical presentation can vary from mild to life-threatening. Our objective is to study the clinical, paraclinical and evolution profile of mediastino-pulmonary sarcoidosis.
Methods: This is a retrospective, descriptive and analytic study conducted over a 20-year period (January 2002 to December 2022). It compiled records of patients who were followed up for confirmed mediastino-pulmonary sarcoidosis.
Results: The study included 35 patients with a mean age of 56.69 ± 14.42 . There was a clear predominance of female patients, with a male-to-female sex ratio of 0.346. The most common functional respiratory signs were dyspnea (82.9%) and dry cough (80%). Extra-respiratory symptoms were noted in 45.7% of cases, with the most common being polyarthralgia (28.6%), xerophthalmia (20%) and xerostomia (14.3%). The most common parenchymal lesions were micronodules (71.4%), nodules (51.4%), and peribronchovascular thickening (40%). The The right upper lobe (77.1%) and middle lobe (74.3%) were the most affected lobes. Hilar adenopathy (71.4%), paratracheal adenopathy (60%), and the aorto-pulmonary window (54.3%) were the most frequent lymph node involvements. Respiratory function tests revealed a restrictive ventilatory defect in 32% of cases and an obstructive ventilatory defect in 13% .Oral corticosteroids were initially administered in 60% of cases. Chronic respiratory failure was observed in 20% of cases. Factors significantly associated with an unfavorable outcome included hemoptysis (p=0.008), the need for corticosteroid treatment (p=0.009), Acute respiratory failure (p=0.05), and echographic dilation of the right cavities (p=0.002).
Conclusions: The clinical phenotype of sarcoidosis can be extremely diverse.Thoracic computed tomography plays an important role in the diagnosis and monitoring of the disease. The evolution of sarcoidosis is variable and depends on the occurrence of complications.
References
2. Rybicki BA, Major M, Popovich J, Maliarik MJ, Iannuzzi MC. Racial differences in sarcoidosis incidence: a 5-year study in a health maintenance organization. Am J Epidemiol. 1997 Feb 1;145(3):234–41.
3. Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med. 2007 Nov 22;357(21):2153–65.
4. Grunewald J, Grutters JC, Arkema EV, et al . Sarcoidosis. Nat Rev Dis Primer. 2019 Jul 4;5(1):1–22.
5. Spagnolo P, Rossi G, Trisolini R, Sverzellati N, Baughman RP, Wells AU. Pulmonary sarcoidosis. Lancet Respir Med. 2018 May;6(5):389–402.
6. Baughman RP, Iannuzzi MC. Diagnosis of sarcoidosis: when is a peek good enough? Chest. 2000 Apr;117(4):931-2.
7. Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med. 1999 Aug;160(2):736–55.
8. Nunes H, Bouvry D, Soler P, Valeyre D. Sarcoidosis. Orphanet J Rare Dis. 2007 Nov 19;2:46.
9. Uzunhan Y, Jeny F, Crockett F, et al. Sarcoïdose pulmonaire : aspects cliniques et modalités thérapeutiques. Rev Médecine Interne . 2016 Sep 1 ;37(9):594–607.
10. Rybicki BA, Iannuzzi MC, Frederick MM, et al. Familial aggregation of sarcoidosis. A case-control etiologic study of sarcoidosis. Am J Respir Crit Care Med. 2001 Dec 1;164(11):2085–91.
11. Sverrild A, Backer V, Kyvik KO, et al. Heredity in sarcoidosis: a registry-based twin study. Thorax. 2008 Oct;63(10):894–6.
12. Aloulou I. Etude clinique de la sarcoïdose: à propos de 20 cas [thèse]. Sfax: Faculté de médecine de sfax; 2017. Chahid Y. Sarcoidose: étude rétrospective de 26 cas [thèse]. Marrakech: Université Cadi Ayyad, Faculté de Médecine et de Pharmacie; 2014.
13. Chahid Y. Sarcoidose: étude rétrospective de 26 cas [thèse]. Marrakech: Université Cadi Ayyad, Faculté de Médecine et de Pharmacie; 2014.
14. Morimoto T, Azuma A, Abe S, et al. Epidemiology of sarcoidosis in Japan. Eur Respir J. 2008 Feb;31(2):372–9.
15. Silva AL, Melo N, Caetano Mota P, et al. Pulmonary Sarcoidosis: Prognostic Factors at Diagnosis in Patients from North of Portugal. Reumatol Clin. 2020;16(6):468–72.
16. Bart PA, Zuber JP, Leimgruber A, Spertini F. Sarcoïdose: nouveaux concepts pathogéniques et thérapeutiques pour une «vieille» maladie Rev. Rev Med Suisse. 2005 Apr 13;015:1026–38.
17. Morar R, Feldman C. Sarcoidosis in Johannesburg, South Africa: A retrospective study. Afr J Thorac Crit Care Med. 2022;28(4).
18. Nunes H, Soler P, Valeyre D. Pulmonary sarcoidosis. Allergy. 2005 ;60(5):565–82.
19. Pohle S, Baty F, Brutsche M. In-Hospital disease Burden of Sarcoidosis in Switzerland from 2002 to 2012. PLOS ONE. 2016 Mar 17;11(3):e0151940.
20. Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988 Jun;124(6):869–71.
21. Koudache A, Embarek ME. Démarche diagnostique et prise en charge de la sarcoïdose pulmonaire [thèse]. Tlemcen: Université Abou Bekr Belkaid; 2014.
22. Alavi A, Akhoundzadeh N, Karkan MF. Sarcoidosis, a report from Guilan (an Iranian Northen province) (2001-09). Sarcoidosis Vasc Diffuse Lung Dis. 2014 ;31(4):282–8.
23. Lynch JP, Kazerooni EA, Gay SE. Pulmonary sarcoidosis. Clin Chest Med. 1997 Dec;18(4):755–85.
24. Fourati H. Imagerie de la sarcoïdose: étude rétrospective de 29 cas de sarcoïdose médiastino-pulmonaire et revue iconographique de ses manifestations extra-thoraciques [thèse]. Sfax: Faculté de Médecine de Sfax; 2008.
25. Müller NL, Kullnig P, Miller RR. The CT findings of pulmonary sarcoidosis: analysis of 25 patients. AJR Am J Roentgenol. 1989 Jun;152(6):1179–82.
26. El Fadili S, Zaghba N, Benjelloun H, Yassine N. L’apport de la bronchoscopie dans le diagnostic positif de la sarcoïdose thoracique. Rev Mal Respir. 2015 Dec 21;32(10):1023–9.
27. Louhaichi S, Smadhi H, Kamoun H, et al. Sarcoïdose médiastino-pulmonaire : quelle démarche diagnostique ? Rev Mal Respir. 2019 Jan 1 ;36: A241.
28. Navarre S, Schneider C, Mura F, Riviere S, Konate A, Arnaud B. Uvéite et sarcoïdose : analyse rétrospective de 25 cas. J Fr Ophtalmol . 2007 Apr 1;30:2S170.
29. Majdoub Fehri S, Aouadi S, Zribi H, Gharssali H, Maalej S, Douik El Gharbi L. Profil évolutif de la sarcoïdose médiastino-pulmonaire chez les patients tunisiens. Rev Mal Respir. 2018 Jan 1 ;35: A126.
30. Winterbauer RH, Kraemer KG. The infectious complications of sarcoidosis: a current perspective. Arch Intern Med. 1976 Dec;136(12):1356–62.
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